Reconstructive Facial Plastic Surgery A Problem Solving Manual 1st Edition by Hilko Weerda ISBN 9781588906755 1588906752

1 Anatomy of the Skin and Skin Flaps

The Skin

Types of Skin Flaps

Random Pattern Flaps

Axial Pattern Flaps

Island Flaps

Myocutaneous Island Flaps

Neurovascular Island Flaps

2 Basic Principles of Facial Surgery

Suture Materials and Techniques

Instruments and Accessories

Wound Management, Repair of Small Defects, and Scar Revision

Relaxed Skin Tension Lines, Vascular Supply, and “Esthetic Units”

Wound Management and Scar Revision

Management of Wounds with Traumatic Tattooing

Scar Revision by W-Plasty and the Broken- Line Technique of Webster (1969)

Small Excisions

Z-Plasty

Postoperative Treatment of Scars

Esthetic Units

Tumor Resection with Histologic Control

Free Skin Grafts

Composite Grafts

Graft Nomenclature

3 Coverage of Defects

Local Flaps

Advancement Flaps

Advancement Flap of Burow (1855)

Burow’s U-Advancement

V-Y and V-Y-S Advancement of Argamaso (1974)

Flaps without Continuous Epithelial Coverage (Rettinger 1996)

Sliding Flap

Pedicled Flaps

Transposition Flap

Rotation Flap

Bilobed Flap

Rhomboid Flap

Turnover Flap

Tubed Pedicle Flap (Bipedicle Flap)

Distant Flaps

Distant Tubed Pedicle Flap

Special Part

Coverage of Defects in Specific Facial Regions

4 Forehead Region

Median Forehead Region

Wedge-Shaped Defects

H-Flap

Double Rotation Flap

Lateral Forehead Defects

Forehead Rotation

5 Nasal Region

Glabella and Nasal Root

U-Advancement Flap of Burow

V-Y Advancement

Sliding Flap

Nasal Dorsum

Bilobed Flap

Island Flap

Rieger Flap

Nasolabial Flap

Cheek Flap

Nasal Tip

Bilobed Flap

V-Y Advancement Flap of Rieger (1957)

Median Forehead Flap

Larger Defects of the Nasal Tip and Ala

Frontotemporal Flap of Schmid and Meyer

Nasal Flank

Flap Advancement of Burow (1855)

Median Cheek Rotation of Sercer (1962)

Burow’s Laterally Based Cheek Advancement Flap

Imre’s Cheek Rotation (1928)

Cheek U-Flap

Island Flap

Sliding Flap

Nasal Ala

Full-Thickness Reconstructions

Z-Plasty of Denonvilliers and Joseph (1931)

Anteriorly Based Alar Rotation (Weerda 1984)

Modification of the Anteriorly Based Alar Rotation

Coverage with a Transposition Flap

Lowering the Alar Rim as a Full-Thickness Bipedicle Flap and with a Composite Graft

Turnover Flap and Composite Graft

Converting a Peripheral to a Central Defect (Haas 1991) and Reconstructing the Alar Rim with a Trans

Wedge-Shaped Defect in the Alar Rim

Nelaton Flap (Nasolabial Flap)

Sliding Flap of Barron et al. (1965) and Lejour (1972) from the Nasolabial Fold

In-and-Out Flap of Peers (1967)

Median Forehead Flap

Bilobed Flap from the Cheek (Weerda 1983)

The Columella

Nelaton Flap

Frontotemporal Flap of Schmid and Meyer (1964)

Composite Graft

Partial and Total Nasal Reconstruction

Converse Scalping Flap (Forehead-Scalp Flap)

Total Nasal Reconstruction with the Sickle Flap (Farrior 1974)

Median Forehead Flap with Soft-Tissue Expansion

Nasal Reconstruction with Distant Flaps

Perforations of the Septum

Small Perforations

Large Defects

Oral Mucosal Flap of Meyer (1988)

Nasolabial Flap of Tipton (1975)

Bipedicled Flap of Schultz-Coulon (1989)

6 The Lips

Mucosal Defects

Wedge-Shaped Defects

Large Superficial Defects

Upper Lip

Median Deficiency

Thin Upper Lip

Thin Upper Lip and Full Lower Lip

Median Scars and Upper Lip Defects

Scar Revisions

Small Contractures

Larger Contractures

Larger Scar Contractures Causing Lip Retraction

Defects in the Nasal Floor and Upper Lip

Transposition Flap from the Nasolabial Fold

Bilobed Flap

Central Defects of the Upper Lip

Celsus Method Combined with an Abbe Flap

Classic Reconstructive Techniques in the Upper Lip

Abbe Flap (1898)

Estlander Flap (1872)

Upper Lip Reconstruction with a Rotation Flap (Blasius 1840)

Upper Lip Reconstruction by the Method of Dean et al. (1975) as Modified by Weerda (1990)

Gillies Fan Flap (1976)

Neurovascular Skin-Muscle-Mucosal Flap of Weerda (1980, 1990)

Lower Lip

Scar Contractures and Small Defects

Small Contractures

Larger Contractures

Small Defects

Lip Reduction

Sliding Flaps in the Vermilion

Classic Lower Lip Reconstructions

Wedge Excision

Estlander Flap (1872)

Vermilion Reconstruction by the Method of von Langenbeck (1855)

Tongue Flap

Brown Modification of the Estlander Flap (1928)

Unilateral or Bilateral Gillies Fan Flap

Universal Method of Bernard (1852), Grimm (1966), and Fries (1971)

Reconstruction of the Lateral Lip and Commissure

Burow’s Method of Reconstructing the Lateral Upper Lip (1855)

Reconstruction of the Commissure by the Method of Rehn (1933) as Modified by Fries (1971) and Brusat

Reconstruction of Large Commissural Defects

Large Full-Thickness Reconstruction of the Cheek and Commissure

Asymmetric Defects of the Commissure and Cheek

Vermilion Defects

Vermilion Advancement of Goldstein (1990)

Elongation of the Oral Fissure

Method of Converse (1959) (Weerda 1983)

Method of Converse (1977)

Method of Ganzer (1921)

Method of Gillies and Millard (1957)

7 The Chin

Coverage of Small Defects in the Chin Area

Advancement Flap

Bilobed Flap

8 The Cheek

Medial Cheek Defects

Upper Medial Cheek

Esser Cheek Rotation (1918)

Cheek Reconstruction Combining the Methods of Esser (1918) and Imre (1928) (Weerda 1980)

Small Cheek Defects

Imre Cheek Advancement Flap (After Haas 1973, Modified)

Modified Esser Cheek Rotation For Nasal Flank Defects

Defect in the Medial Canthus

Mid-Anterior Cheek

Pedicled Bilobed Flaps

V-Y Advancement

Upper and Posterior Cheek

Trilobed Flap of Weerda (1979)

Bilobed Flap

Lateral Cheek Defects

Small Lateral Cheek Defects

Small Preauricular Defects

Simple Skin Advancement and Rotation (Burow’s Method)

Opposing Transposition Flaps

Large Defects Involving the Auricle

Lateral Cheek Rotation of Weerda (1980c)

Pedicled Transposition Flaps

Preauricular Hair Loss

Inferiorly Based Retroauricular Transposition Flap (Weerda 1978a)

Large Bilobed Flap from the Neck (Weerda 1980b)

9 The Eyelids

Upper Eyelid

Direct Closure

Semicircular Flap Closure of Beyer-Machule et al. (1993)

Switch Flap

Upper Eyelid Reconstruction of Fricke and Kreibig

Bilobed Flap

Total Upper Lid Reconstruction by the Two-Stage Mustarde Technique (Beyer-Machule and Riedel 1993)

Reconstruction of the Lower Eyelid

Reconstruction of Small Defects in the Lower Eyelid

Large Defects

Reconstruction of the Lower Lid with Ectropion

Transposition Flap

Total Lower Lid Reconstruction

Reconstruction of the Medial Canthus

10 The Auricular Region

Central Defects

Concha

Postauricular Island Flap

Superiorly or Inferiorly Based Transposition Flap

Temporary Separation of the Helix (Weerda 1984)

Peripheral Defects

Helix

Tumor Resection and Helical Defect Closure with a Decrease in Auricular Size

Reconstruction of Helical Defects with Preservation of Auricular Size

Partial Auricular Defects

Upper Third Defects

Middle Third Defects

Burow’s Retroauricular U-Advancement Flap

Transposition-Rotation Flap of Weerda (1980b)

Larger Middle Third Defects

Lower Third Defects

Earlobe Reconstruction by the Gavello Technique

Weerda’s Modification of the Gavello Flap

Earlobe Reconstruction by the Alanis Technique

Earlobe Reconstruction in Two Stages

Acquired Earlobe Cleft

Earlobe Reduction

Postauricular Surface

Subtotal Defects of the Auricle

Loss of the Auricle

Fresh Avulsion Injuries

Microvascular Replantation

Replantation of the Auricular Cartilage

Replantation by the Technique of Mladick (1971)

Auricular Replantation by the Technique of Baudet (1972) and Arfai (1974) (Weerda 1980)

Auricular Reconstruction Following Total Amputation

Reconstruction of the Ear or Auricular Region in Patients with Skin Loss or Burns

Fan Flap of Parietotemporal Fascia

Closure of Defects in the Auricular Region

11 Rib Cartilage

Obtaining Rib Cartilage

Preparation of Cartilage Grafts

Carving an Auricular Framework

12 Myocutaneous Island Flaps

Pectoralis Major Island Flap

Latissimus Dorsi Island Flap

Neurovascular Infrahyoid Myofascial Flap of Remmert (1994)

13 Deltopectoral Flap

14 Free Flaps

Radial Forearm Flap

Allen Test

Groin Flap

Microvascular Surgery

Instrumentation

Practicing for Microvascular Surgery

Knot-Tying Practice Under a Microscope or Binocular Loupe

Microvascular Anastomosis in an Experimental Animal: Vascular Dissection in the Rat

Problems and Complications

Test for Patency

15 Harvesting a Bone Graft from the Iliac Crest

16 Dermabrasion

References

Index